Whether you have migraines, tension type headaches, cervicogenic headaches or a combination of any of these, treating the neck can help. Research shows that physical therapy can help reduce pain intensity, headache frequency and headache duration for any of these types of headaches. When a patient complaining of headaches, walks into my clinic there are 3 main areas to evaluate to see if this person is a good candidate for physical therapy.
1. Muscles
Muscles in the neck need to be evaluated to see if they are contributing to the neck. Each cervical muscle has a predictable referral pattern and each muscle should be examined to see if it replicates your headache. The most common muscles causing headaches that I see in my patients are:
- Upper Trapezius
- Suboccipitals
- Sternocleidomastoid
- Semispianlis capitis and cervicis
- Splenius capitis and cervicis
2. Nerves
Patients who complain of lightening rod pain, burning or heat with their headaches should have a few key nerves evaluated. If a headache comes on after trauma, these nerves can become irritated. Nerve pain needs to be treated differently than muscle derived pain. For example, ice works better for those with nerve irritability, whereas heat feels better to those with referred muscle pain. Key nerves to examine:
- Supratrochlear Nerve
- Supraorbital Nerve
- Lesser Occipital Nerve
- Greater Occipital Nerve
3. Joints
Joints in the neck can refer pain up into the head – it is just how our nervous system is wired. Overall research points to C2, or the 2nd vertebrae in our neck, as being the most common level involved in cervicogenic headaches. When it comes to the spine, the upper 3 vertebrae are going to most likely to be contributing to your headaches versus joints below those levels.
Other Considerations
These are the main 3 structures to always assess if you suffer from migraines, tension type headaches or cervicogenic headaches. However, there are other causes of headaches that should be considered. An evaluation with a physical therapist who specializes in treating headaches can perform a thorough evaluation and develop a personalized treatment plan to address your unique concerns.
The Headache Therapist 